Your browser doesn't support javascript.
loading
Management of Open Tibial Shaft Fractures: Does the Timing of Surgery Affect Outcomes?
Duyos, Oscar A; Beaton-Comulada, David; Davila-Parrilla, Ariel; Perez-Lopez, Jose Carlos; Ortiz, Krystal; Foy-Parrilla, Christian; Lopez-Gonzalez, Francisco.
Afiliação
  • Duyos OA; From the Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
J Am Acad Orthop Surg ; 25(3): 230-238, 2017 Mar.
Article em En | MEDLINE | ID: mdl-28199292
BACKGROUND: Open tibial shaft fractures require emergent care. Treatment with intravenous antibiotics and fracture débridement within 6 to 24 hours is recommended. Few studies have examined outcomes when surgical treatment is performed >24 hours after occurrence of the fracture. METHODS: This retrospective study included 227 patients aged ≥18 years with isolated open tibial shaft fractures in whom the time to initial débridement was >24 hours. The statistical analysis was based on time from injury to surgical débridement, Gustilo-Anderson classification, method of fixation, union status, and infection status. RESULTS: Fractures débrided within 24 to 48 hours and 48 to 96 hours after injury did not show a statistically significant difference in terms of infection rates (P = 0.984). External fixation showed significantly greater infection rates (P = 0.044) and nonunion rates (P = 0.001) compared with intramedullary nailing. CONCLUSION: Open tibial shaft fractures should be débrided within 24 hours after injury. Our data indicate that after the 24-hour period and up to 4 days, the risk of infection remains relatively constant independent of the time to débridement. Patients treated with external fixation had more complications than did patients treated with other methods of fixation. Primary reamed intramedullary nailing appears to be a reasonable option for the management of Gustilo-Anderson types 1 and 2 open tibial shaft fractures. LEVEL OF EVIDENCE: Level III retrospective study.
Assuntos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Tíbia / Desbridamento / Fixação de Fratura / Fraturas Expostas Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Orthop Surg Assunto da revista: ORTOPEDIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Porto Rico País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Tíbia / Desbridamento / Fixação de Fratura / Fraturas Expostas Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Orthop Surg Assunto da revista: ORTOPEDIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Porto Rico País de publicação: Estados Unidos